| Eastern Nephrology, Pc | |
|
1524 Huffman Road Birmingham AL 35215 | |
| (205) 856-0011 | |
| (205) 856-0726 |
| Full Name | Eastern Nephrology, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1524 Huffman Road, Birmingham, Alabama |
| Authorized Official Name and Position | Kelly F Amerson (BILLING) |
| Authorized Official Contact | 2058560011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Nephrology, Pc 1524 Huffman Road Birmingham AL 35215 Ph: (205) 856-0011 | Eastern Nephrology, Pc 1524 Huffman Road Birmingham AL 35215 Ph: (205) 856-0011 |
| NPI Number | 1093896466 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 05/10/2012 |
| Medicare PECOS PAC ID | 7416927603 |
|---|---|
| Medicare Enrollment ID | O20040727000347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093896466 | NPI | - | NPPES |
| 000011134 | Medicaid | AL | |
| 009961755 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 00007283 (Alabama) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | 0007283 (Alabama) | Secondary |
| Provider Name | Pei Yan Chen |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1952327157 PECOS PAC ID: 4183694052 Enrollment ID: I20040728000799 |
| Provider Name | Rahim Kassamali |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1932162641 PECOS PAC ID: 2961398862 Enrollment ID: I20111027000808 |
| Provider Name | Vijay K Caplash |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1225054406 PECOS PAC ID: 8123098316 Enrollment ID: I20111220000453 |
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